| NPI | 1902375736 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRYSTAL D BENSON President 702-600-7977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2018-11-21 |
| Last Update Date | 2021-01-22 |